Mr Kimi San Miguel Diaz, MS, PA-C - Medicare Physician Assistant in Peabody, MA

Mr Kimi San Miguel Diaz, MS, PA-C is a medicare enrolled "Physician Assistant" in Peabody, Massachusetts. His current practice location is 300 Jubilee Dr, Peabody, Massachusetts. You can reach out to his office (for appointments etc.) via phone at (978) 513-7588.

Mr Kimi San Miguel Diaz is licensed to practice in New York (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1114632510.

Contact Information

Mr Kimi San Miguel Diaz, MS, PA-C
300 Jubilee Dr,
Peabody, MA 01960-4068
(978) 513-7588
Not Available



Provider's Profile

Full NameMr Kimi San Miguel Diaz
GenderMale
SpecialityPhysician Assistant
Location300 Jubilee Dr, Peabody, Massachusetts
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1114632510
  • Provider Enumeration Date: 01/19/2023
  • Last Update Date: 10/23/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 2163879685
  • Enrollment ID: I20231106001158

Medical Identifiers

Medical identifiers for Mr Kimi San Miguel Diaz such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1114632510NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363A00000XPhysician Assistant (New York)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Kimi San Miguel Diaz is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mr Kimi San Miguel Diaz, MS, PA-C
Po Box 163,
Mongaup Valley, NY 12762-0163

Ph: () -
Mr Kimi San Miguel Diaz, MS, PA-C
300 Jubilee Dr,
Peabody, MA 01960-4068

Ph: (978) 513-7588

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› Verified 7 days ago


Physician Assistant Nurses in Peabody, MA

Andrew Shaheen, PA
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 1 Essex Center Dr, Peabody, MA 01960
Phone: 978-538-4000    
Kellie Condon, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 2 Essex Center Dr Ste 1, Peabody, MA 01960
Phone: 978-977-4000    
Linda S Southwick, PA
Physician Assistant
Medicare: Not Enrolled in Medicare
Practice Location: 2 Essex Center Dr, Peabody, MA 01960
Phone: 978-977-4000    
Jarett S Landman, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 1 Orthopedics Dr, Peabody, MA 01960
Phone: 978-818-6350    Fax: 978-818-6355
Mr. David Matthew Alden-st.pierre, PA-C
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 1 Roosevelt Ave, Suite 201, Peabody, MA 01960
Phone: 978-536-0215    
Kathryn Courtney Luck, PA
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: Lahey Medical Center, Peabody, 1 Essex Center Drive, Peabody, MA 01960
Phone: 978-538-4267    Fax: 978-538-4706

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